Bone and joint tuberculosis

Is observed mainly in childhood and adolescence and occurs in most cases asmapoarthritis (lesion of one joint) or as an isolated lesion of the spine. Most often begins in the bones with a densely developed vascular system: vertebrae, wrist bones, feet, and other limb bones in their periarticular part. The frequency of joint damage has the following sequence: knee, hip, ankle, elbow, shoulder, which is due to varying degrees of their load. As a rule, multiple lesions of small joints and single - large ones are observed.
The process develops in phases. Phase 1: development of primary osteitis followed by a curdled bone decay. Phase 2: destruction of the articular cartilage and opening of the tubercle focus in the joint with its seeding and accumulation in the cavity of exudate effusion. In the future, the joint sprouts mushroom-shaped masses with their subsequent disintegration and the formation of an abscess. When the abscess breaks through the skin, fistulas with a purulent discharge are formed, in which the mycobacterium tuberculosis is detected. 3 phase: postartritic. Due to the destruction of cartilage and articular surfaces, joint deformity and its ankylosis (immobility) occur. When the spine is injured due to the curdled decay of the bone focus, the sphenoid deformity of the vertebrae and the development of the hump occur. At the same time, abscesses are formed.
Early diagnosis of tuberculosis of bones and joints is difficult, as the patient consults a doctor only with a sharp violation of the functions of the affected organ.
Symptoms and course are typical for tuberculous intoxication: fast fatigue, lethargy, sweating, decreased appetite, gradually losing weight, occasionally a slight increase in body temperature in the evenings to subfebrile (37,337.5 ± C). Early signs of osteoarticular tuberculosis are pain, limitation of mobility, atrophy and muscle tension near the affected area. The later symptoms include the formation of fistulas, from which liquid pus with an admixture of caseous, having a curdled appearance, is secreted. In the study of these secretions, mycobacteria of tuberculosis are found, the pattern of blood changes accordingly, and also roentgenological data are also characteristic.